Volume 14, Number 2—February 2008
Cost-effectiveness of Human Papillomavirus Vaccination in the United States
|Variable||Goldie et al. 2004 (10)||Sanders and Taira 2003 (11)||Taira et al. 2004 (13)||Elbasha et al. 2007 (9)|
|Key assumptions in published models|
|Target of HPV vaccine||HPV 16,18||High risk HPV types||HPV 16,18||HPV 6,11,16,18|
|Efficacy of vaccine||90%||75%||90%||100%‡|
|Vaccine cost per series||$393||$300||$300 + $100 booster||$360|
| Base year of $US
|Estimated cost per QALY of vaccination|
|Published model estimate||$24,300||$12,700§||$14,600||$3,000|
|Simplified model estimate||$20,600||$8,700||$17,100||$5,300|
*QALY, quality-adjusted life year; HPV, human papillomavirus.
†In all comparisons, the simplified model was modified (as necessary) so that the assumptions regarding the target of the HPV vaccine, vaccine efficacy and cost, vaccine duration of protection (except in the comparison to Taira and colleagues , as noted in the Technical Appendix, and the base year of US$ were consistent with the published models (Technical Appendix). The simplified model estimate was based on the cohort model in the comparisons with the findings of Goldie et al. (10) and Sanders and Taira (11) and was based on the population model (assuming transmission effects) in the comparison with the estimates of Taira and colleagues (13) and Elbasha and colleagues (9).
‡Elbasha and colleagues (9) assumed 90% protection against infection with HPV and 100% protection against HPV-related disease.§To enhance comparability, the published estimate from Sanders and Taira (11) was based on their sensitivity analyses when assuming lifetime duration of vaccination, not their base-case estimate of $22,800 when 10-y vaccine duration of protection was assumed.